Individual
KATHLEEN C MIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 LAS GALLINAS AVE, SAN RAFAEL, CA 94903-1843
(415) 491-6616
Mailing address
1111 LAS GALLINAS AVE, PETALUMA, CA 94954-5421
(415) 491-6616
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
05/28/2026
Last updated
05/28/2026
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